某院门诊2003—2005年地高辛合并用药分析  

Recipe Analysis of Digoxin in Outpatients from a Perspective of Pharmacokinetic Interaction

作　　者：王欧明[1] 宋美芳[1] 周权[1] 

机构地区：[1]浙江大学医学院附属二院,浙江杭州310009

出　　处：《中国药业》2006年第18期43-45,共3页China Pharmaceuticals

摘　　要：目的了解地高辛的合并用药情况,为临床合理用药提供参考。方法利用浙江省医院管理系统药房管理子系统,对2003年3月～2005年12月期间某院所有含地高辛的门诊处方进行回顾性分析。结果与地高辛有药代动力学相互作用的合并用药包括11种口服抗菌药物、13种P-糖蛋白抑制剂和2种促胃肠动力药,分别占地高辛总处方量的5.5%,64.7%和0.7%。同一张处方中与地高辛并用药物含2种以上P-糖蛋白抑制剂的占5.2%,含口服抗菌药物与P-糖蛋白抑制剂的占3.2%。结论地高辛在目前临床合并用药中,产生药代动力学相互作用的可能性较大。药师应做好处方审查和患者用药教育;在加用或撤除一些并用药物时,必须注意可能引起的地高辛药代动力学变化;必要时对某些可疑相互作用进行血药浓度监测。Ohjeetive To learn the current status in clinical use of digoxin and to guide the clinicians to use it rationally. Methods Using a pharmacy administration software,the outpatient recipes containing digoxin in one hospital were analyzed retrospectively. Results In digoxin concurrent therapy, 11 kinds of antimicrobial agents（5.5% of the total digoxin-containing recipes）, 13 kinds of P-glycoprotein inhibitors （64.7%） and 2 kinds of prokinetic agents（0.7% ） had clinically significant drug interactions with digoxin. There were 157 recipes concomitantly containing two P-glycoprotein inhibitors（5.2% ）,97 recipes concomitantly containing one P-glycoprotein inhibitor plus one more antimicrobial agents（3.2% ）. Conclusion The risk of pharmacokinetic interactions in digoxin concurrent therapy exists. Pharmacists should enhance recipe censoring and patient education in digoxin concurrent therapy and maintain constant vigilance whenever medications are added to or withdrawn from a therapeutic regimen including digoxin. Therapeutic drug monitoring may be taken in case of verifying some suspected drug interactions.

关 键 词：地高辛 药代动力学 药物相互作用 用药分析 

分 类 号：R969.3[医药卫生—药理学] R972.1[医药卫生—药学]